Candidiasis of the urinary tract
Last reviewed: 23.04.2024
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[Symptoms of the candidiasis of the urinary tract
Candidiasis is characterized by frequent painful urination. Candida pyelonephritis is characterized by pain in the lumbar region, fever and pain when urinating.
Diagnostics of the candidiasis of the urinary tract
Diagnosis of candidiasis of the urinary tract is based on the detection of Candida spp. In urine and assessment of the patient's condition. It is important to correctly understand the clinical significance of the detection of Candida spp. In the urine. Most patients have asymptomatic candiduria, which indicates the colonization of Candida spp. Lower urinary tract, this fact is not considered an indication for the use of antimycotics (sufficient elimination or correction of risk factors).
Candiduria in combination with clinical or instrumental signs of urinary tract infection is an indication for the use of antifungal drugs. In addition, candidiasis of the urinary tract can be a source, and candiduria - a manifestation of invasive candidiasis. That is why, at a high risk of developing invasive candidiasis (the presence of risk factors, presumed clinical signs), an additional examination and decision on the appointment of antifungal therapy are indicated.
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Treatment of the candidiasis of the urinary tract
Treatment is carried out by patients with clinical signs of urinary tract infection or with asymptomatic candiduria and the presence of risk factors for the development of invasive candidiasis. Treatment of candidiasis of the urinary tract consists in the use of systemic antimycotics, the removal or replacement of urinary catheters, in the elimination or reduction of the severity of other risk factors (optimization of the use of antibacterial drugs, correction of diabetes, etc.). The drug of choice is fluconazole, unlike other antimycotics, it creates a high concentration of the active substance in the urine. When fluconazole is ineffective, bladder washing with amphotericin B solution (50-200 μg / ml), usually accompanied by a temporary cessation of candiduria, is used, but this method of treatment is ineffective in the case of the lesion of the overlying parts of the urinary tract. With fluconazole ineffectiveness and possible damage to the renal parenchyma, caspofungin or voriconazole is used.
With asymptomatic candiduria in patients without risk factors for invasive candidiasis, antimycotics are not used. Eliminating or reducing the risk factors for urinary tract candidiasis (removing or replacing the urinary catheter, optimizing the use of antibacterial drugs, correcting diabetes mellitus, and so on) usually leads to the elimination of asymptomatic candiduria.